摘要
目的了解新疆地区健康儿童百日咳血清特异性IgG抗体水平,调查本地区小儿百日咳的感染率,探讨百日咳患儿的临床及分子流行病学特点。方法随机选取新疆地区健康儿童445例作为对照,根据年龄分为8个组,取其血清,应用ELISA法测定特异性百日咳IgG抗体。同时选择新疆医科大学第一附属医院163例可疑百日咳患儿作为研究对象,分别取鼻咽拭子及血清标本,应用聚合酶链反应(PCR)法检测其百日咳杆菌的双目标基因(插入区域IS481以及百日咳毒素S1促进区域),ELISA法检测特异性IgG抗体以及碳琼脂培养基培养鲍特百日咳杆菌;应用脉冲场凝胶电泳(PFGE)对检测出的鲍特百日咳杆菌进行分子流行病学研究。结果健康儿童百日咳IgG抗体水平以2～3岁最高,0～5个月最低,12～14岁组处于较低水平。确诊百日咳患儿26例中,百日咳特异性IgG抗体为(127.63±12.75)g/L,余137例非百日咳患儿为(7.71±16.32)g/L,确诊百日咳患儿百日咳特异性IgG抗体水平明显高于非百日咳患儿患儿(F=5.837 P<0.05);非百日咳患儿与健康对照组[(6.07±17.79)g/L]比较,差异无统计学意义。可疑患儿血清学阳性例数以7～15岁组最高(43/163例,占26.19%),1～11个月组21/163例(12.82%),1～3岁组为11/163例(6.67%),4～6岁组为8/163例(5.0%);≥7岁者血清学阳性占21.92%,<7岁者仅为9.68%,二者比较有显著差异(χ2=7.6975 P<0.05);未接种儿童百日咳特异性抗体阳性率(14/35例)明显高于接种过百日咳疫苗的儿童(22/128例),其差异有统计学意义(χ2=16.3358 P<0.001)。可疑百日咳163患儿中26例百日咳特异性抗体阳性,其中24例(92.31%)PCR检测阳性,百日咳杆菌特异性培养无阳性结果;将PCR阳性标本经XbaI限制性内切酶消化后在48～630kb产生9～14个DNA片段,共得14个PFGE核型。结论应对年长儿进行百日咳疫苗的免疫。PCR是诊断百日咳感染的一项快速、敏感、易行、实用的工具,与血清学
Objective To understand the serological specific antibody levels of immunization against bordetella pertussis in healthy, children, survey the prevalence of bordetella pertussis infection of children, and analyze its clinical characteristics. Methods Four hundred and forty - five healthy children were randomly selected from Xinjiang area who were divided into 8 groups according to their ages, specific IgG antibody was tested by enzyme - linked immunosorbent assay（ELISA）. One hundren and sixty - three patients in our hospital with definitive pertussis were chosen. Nasopharyngeal swabs were taken from all patients with PCR detecting two - goal bordetella, pertussis gene（ the insertion element IS481 and pertussis toxin S1 promoter） and bacterial culture. The same amount of sera was detected for pertussis toxin IgG and filamentous hemaglutinin IgG by ELISA. Pulsed field gel elevtrophoresis（PFGE） typing were detected by XbaI and Spel digestion. Results In healthy children,pertussis IgG antibody levels of 2 - 3 years old children was the highest, the lowest was 0 - 5 months old children, a lo-wer level in 12 - 14 years old group. In the finally diagnoed patients（ n = 26） ,the pertussis IgG antibody levels were （ 127.63 ± 12.75 ） g/L, while of the levels other patients （n = 137 ） were （7.71 ± 16.32 ） g/L, the final diagnosis patients＇ level were significantly higher than those of the other patients （ F = 5. 837 P 〈 0.05 ） ; the levels of other patients without pertussis had no significant difference compared with those of healthy children[ （6.07 ± 17.79） g/L]. The number of the suspected cases by serological detection was maximum in the 7 - 15 years old group （43/163 cases,26.19% ）, 1 - 11 months group was 21/163 cases（ 12.82% ）, 1 - 3 years old group was 11 / 163 cases（ 6.67% ） ,4 - 6 years old was 8/163 cases（5.0% ） ;there was 21.92% in≥ 7 years old group and only 9.68% in 〈 7 years old,there was a significant difference among age groups （X2 = 7. 697 5 P
出处
《实用儿科临床杂志》
CAS
CSCD
北大核心
2008年第22期1745-1749,共5页
Journal of Applied Clinical Pediatrics
基金
教育部春晖课题资助(Z2004-1-65015)
关键词
百日咳感染
聚合酶链反应
细菌培养
脉冲场凝胶电泳
bordetella pertussis infection
polymerase chain reaction
bacteria cuhure
pulsed field gel electrophoresis
